Primavera otoño 2020 (Año LXIII Núms. 122-123)

horizontes@pucpr.edu Año LXIV Núm. 124-125 horizontes PRIMAVERA / OTOÑO 2021 PUCPR 45 rate and increased diaphragmatic excursion. BC included normal tidal breathing focusing on the lower chest to encourage relaxation of the upper chest and shoulders to allow lower chest and abdomen movement (Jones et al., 2017). After intense exercise by normal subjects, breathing control-enhanced diaphragmatic excursion and reduced respiratory rate. Researchers used deep breathing for psychological disorders, including stress, anxiety, and bipolar disorder. Perciavalle et al. (2017) indicated deep breathing was a fundamental technique used in various relaxation methods, incorporating gigong, yoga, and progressive muscle relaxation. They demonstrated that emotions and stress produced interrelated functional changes, mainly through the autonomic nervous system, endocrine system, and immune system. Researchers investigated the effects of deep breathing on mood and stress not only with self- reported evaluations but also by measuring objective parameters. The improvements occurred for the physiological effects (heart rate and salivary cortisol levels), mood, and perceived stress. The deep-breathing technique helped emotions and pain. Stress could be measured and analyzed using both neural and endocrine axis measurements related to stress response physiology (Mejía-Mejía et al., 2017). Researchers evaluated the relationship of acute stress, controlled breathing, physiological coherence (coordinated brain and heart related to well-being and improvements in cognitive performance), and the degree of body-system synchronization during a coherence-generation exercise. Mejía-Mejía et al. (2017) showed higher coherence ratios obtained by controlling breathing during a 5-min period. These higher coherence ratios validated the assumption that slow breathing positively affected heart rate variability in response to stress, including lowering anxiety levels. Slow breathing was an essential component of behavioral interventions. Untrained people could practice slow breathing to synchronize, high coherence state, and cardiorespiratory rate. Deep breathing increased activation of the autonomic parasympathetic nervous system, which increased neural plasticity and altered information processing, making treatment possible for psychological disorders and stress by reducing anxiety, insomnia, and other symptoms. Serafim et al. (2019) studied the benefits of the deep-breathing technique to stabilize the autonomic nervous system, increased heart rate variability, decreased blood pressure, increased lung function, increase immune function, increase blood-lymph flow, improve digestion, improve sleep quality, increase biopsychosocial well-being and quality of life. They verified if a deep-breathing protocol was a feasible and effective treatment for anxiety in bipolar disorder patients. The technique was an effective and lasting adjuvant (enhancement of immune response) anxiety treatment in bipolar patients. Deep breathing was a necessary adjuvant treatment for these patients. This treatment could be included in psychoeducation protocols. Researchers combined non-pharmacological methods, deep- breathing, and spiritual therapy, to relieve pain and anxiety in postoperative orthopedic patients with nonpathological fractures. The endogenous analgesia system was the pathway from the brainstem to the spinal cord to inhibit spinal/ trigeminal nociceptive processing. Combining deep-breathing exercise with spiritual therapy could manipulate the pain mechanism between the endogenous analgesic system and the posterior corpus to block pain (Yusuf et al., 2020). Combining spiritual therapy with deep-breathing exercise reduced anxiety more for postoperative orthopedic patients than standard therapy using the pain reliever ketorolac.